Miliary cerebral metastases

Case contributed by Dr Ian Bickle

Presentation

Middle aged female with a history of breast cancer.

Patient Data

Age: 50
Gender: Female
CT

Subtle small enhancing nodules are present throughout the brain, particulary at the grey white matter interface and possibly on the surface of the brain. 

MRI

Limited sequences due to patient cooperation. Some shown subject to movement artifact.

Innumerable small nodular regions of enhancement are seen throughout the brain.

Case Discussion

Leptomeningeal metastases are fairly uncommon and aside from with a contrast enhanced MRI can be fairly subtle to identify and breast cancer is the classic causative primary.

This case if a far less common form of diffuse metastatic disease: miliary cerebral metastases (aka carcinomatous encephalitis) and represent widespread haematogenous spread of disease. 

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Case information

rID: 26286
Case created: 11th Dec 2013
Last edited: 7th Mar 2016
Inclusion in quiz mode: Included

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